title: Does screening for distress efficiently uncover meetable unmet needs in cancer patients?
abstract: OBJECTIVE
  We evaluated screening for distress in terms of its ability to uncover unmet need for psychosocial services in cancer patients. Correlates of distress, need for services and met and unmet need for services were investigated.
  
  
  METHODS
  Immediately after cancer treatment (T1) and 2 months later (T2), 302 patients completed the Hopkins Symptom Checklist-25 (HSCL-25) and a single question assessing the need for services. All distressed patients (HSCL-25≥39) and non-distressed patients endorsing a need for services were then called (n = 99) to assess their need.
  
  
  RESULTS
  Thirty-seven percent (T1) and 31% (T2) of patients were distressed and 31% (T1) and 18% (T2) expressed the need for services. Both time points showed higher distress in younger patients and females and lower distress in prostate cancer and patients treated by radiotherapy only. Less need for services was found in prostate cancer (T1), greater need was related to being single (T1) and younger (T2). Distress and need for services were positively related (p<0.001). The HSCL-25 showed modest sensitivity (T1: 0.59, T2: 0.65) and specificity (T1: 0.75, T2: 0.78) as an indicator of need for services. Interviews at T2 revealed that 51% of distressed patients needed no psychosocial services and 25% were already receiving services. At T2, regardless of distress level, 10% of all screened patients reported an unmet need for psychosocial services.
  
  
  CONCLUSIONS
  Depending on the clinical context, screening might be more efficient if it assessed the unmet need for services rather than distress. More attention should be concentrated on directing patients with meetable unmet needs to available services.
authors.affiliation: Health Psychology Section, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. c.van.scheppingen@med.umcg.nl
authors.forename: Corinne
authors.initials: C
authors.lastname: van Scheppingen
authors.forename: Maya J
authors.initials: MJ
authors.lastname: Schroevers
authors.forename: Ans
authors.initials: A
authors.lastname: Smink
authors.forename: Yvette M
authors.initials: YM
authors.lastname: van der Linden
authors.forename: Véronique E
authors.initials: VE
authors.lastname: Mul
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Langendijk
authors.forename: James C
authors.initials: JC
authors.lastname: Coyne
authors.forename: Robbert
authors.initials: R
authors.lastname: Sanderman
mesh_terms: D000275:Adjustment Disorders / Q000175:diagnosis* / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D008297:Male; D008403:Mass Screening; D008605:Mental Health Services; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D009426:Netherlands; D011795:Surveys and Questionnaires